Individual provider Active NPI

Jessica Dennis, LCPC

  • Professional Counselor
  • Joliet, IL
National Provider Identifier
1154660355
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.009092 Issued in IL
Practice address
3033 W Jefferson St
#107
Joliet, IL 60435-5261
Phone
(815) 773-0772
Fax
(815) 773-0771
NPI assigned
Feb 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178008574 IL
Professional Counselor 101YP2500X 180.009092 IL Primary

Addresses

Primary practice location

3033 W Jefferson St
#107
Joliet, IL 60435-5261

Mailing address

925 Sheridan Cir
Naperville, IL 60563
Phone (773) 875-5168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
178008574ILMDMental Health Counselor
180.009092ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Counsel for Mental Health Current Accepting new patients
Summit Center for Mental Health Inc Professional PastSince Jul 1, 2015 Accepting new patients

Locations

440 W Boughton Rd
Ste 103
Bolingbrook, IL 60440
Phone (630) 882-5433

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1154660355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 SHERIDAN CIR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60563",
            "telephone_number": "773-875-5168",
            "fax_number": "815-773-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 W JEFFERSON ST",
            "address_2": "#107",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355261",
            "telephone_number": "815-773-0772",
            "fax_number": "815-773-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "JESSICA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-07",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178008574",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.009092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.